NPIMap

Individual provider Active NPI

Daniel Miranda Fonseca, MSW

  • Clinical Social Worker
  • Bayamon, PR
National Provider Identifier
1659758399
Registry record updated May 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12842 Issued in PR
Practice address
Cond Magnolia GDNS
P-12
Bayamon, PR 00956-7100
Phone
(787) 785-9282
Fax
(787) 200-0482
NPI assigned
May 1, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 12842 PR Primary

Addresses

Primary practice location

Cond Magnolia GDNS
P-12
Bayamon, PR 00956-7100

Mailing address

Cond Magnolia GDNS
P-12
Bayamon, PR 00956-7100
Phone (787) 785-9282

Other identifiers 1

IdentifierTypeStateIssuer
12842OtherPRLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Therapy & Health Services, PSC Clinical Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1430438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430438400000",
    "number": "1659758399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "COND MAGNOLIA GDNS",
            "address_2": "P-12",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009567100",
            "telephone_number": "787-785-9282",
            "fax_number": "787-200-0482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "COND MAGNOLIA GDNS",
            "address_2": "P-12",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009567100",
            "telephone_number": "787-785-9282",
            "fax_number": "787-200-0482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA FONSECA",
        "first_name": "DANIEL",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-01",
        "last_updated": "2015-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PR",
            "license": "12842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "12842",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.